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Uptake and retentio...
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Kagaayi, JosephRakai Hlth Sci Program, Kalisizo, Uganda; Makerere Univ, Sch Publ Hlth, New Mulago Hill Rd,POB 7062, Kampala, Uganda
(author)
Uptake and retention on HIV pre-exposure prophylaxis among key and priority populations in South-Central Uganda
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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2020-08-12
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Wiley,2020
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-431454
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-431454URI
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https://doi.org/10.1002/jia2.25588DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:145349286URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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IntroductionPre‐exposure prophylaxis (PrEP) programmes have been initiated in sub‐Saharan Africa to prevent HIV acquisition in key populations at increased risk. However, data on PrEP uptake and retention in high‐risk African communities are limited. We evaluated PrEP uptake and retention in HIV hyperendemic fishing villages and trading centres in south‐central Uganda between April 2018 and March 2019.MethodsPrEP eligibility was assessed using a national risk screening tool. Programme data were used to evaluate uptake and retention over 12 months. Multivariable modified Poisson regression estimated adjusted prevalence ratios (aPR) and 95% Confidence intervals (CIs) of uptake associated with covariates. We used Kaplan–Meier analysis to estimate retention and multivariable Cox regression to estimate adjusted relative hazards (aRH) and 95% CIs of discontinuation associated with covariates.Results and discussionOf the 2985 HIV‐negative individuals screened; 2750 (92.1 %) were eligible; of whom 2,536 (92.2%) accepted PrEP. Male (aPR = 0.91, 95% CI = 0.85 to 0.97) and female (aPR = 0.85, 95% CI = 0.77 to 0.94) fisher folk were less likely to accept compared to HIV‐discordant couples. Median retention was 45.4 days for both men and women, whereas retention was higher among women (log rank, p < 0.001) overall. PrEP discontinuation was higher among female sex workers (aRH = 1.42, 95% CI = 1.09 to 1.83) and female fisher folk (aRH = 1.99, 95% CI = 1.46 to 2.72), compared to women in discordant couples. Male fisher folk (aRH = 1.37, 95% CI = 1.07 to 1.76) and male truck drivers (aRH = 1.49, 95% CI = 1.14 to 1.94) were more likely to discontinue compared to men in discordant couples. Women 30 to 34 years tended to have lower discontinuation rates compared to adolescents 15 to 19 years (RH = 0.78 [95% CI = 0.63 to 0.96]).ConclusionsPrEP uptake was high, but retention was very low especially among those at the highest risk of HIV: fisher folk, sex workers and truck drivers and adolescent girls. Research on reasons for PrEP discontinuation could help optimize retention.
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Batte, JamesRakai Hlth Sci Program, Kalisizo, Uganda
(author)
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Nakawooya, HadijjaRakai Hlth Sci Program, Kalisizo, Uganda
(author)
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Kigozi, BonifaceRakai Hlth Sci Program, Kalisizo, Uganda
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Nakigozi, GertrudeRakai Hlth Sci Program, Kalisizo, Uganda
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Strömdahl, SusanneKarolinska Institutet,Uppsala universitet,Infektionssjukdomar,Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden; Karolinska Inst, Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden(Swepub:uu)susst222
(author)
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Ekstroem, Anna MiaKarolinska Institutet,Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden; Karolinska Inst, Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden
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Chang, Larry W.Rakai Hlth Sci Program, Kalisizo, Uganda; Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA; Johns Hopkins Sch Med, Baltimore, MD USA
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Gray, RonJohns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
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Reynolds, Steven J.Rakai Hlth Sci Program, Kalisizo, Uganda; Johns Hopkins Sch Med, Baltimore, MD USA; NIAID, Div Intramural Res, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA
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Komaketch, PatrickCtr Dis Control & Prevent, Kampala, Uganda
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Alamo, StellaCtr Dis Control & Prevent, Kampala, Uganda
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Serwadda, DavidRakai Hlth Sci Program, Kalisizo, Uganda; Makerere Univ, Sch Publ Hlth, New Mulago Hill Rd,POB 7062, Kampala, Uganda
(author)
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Rakai Hlth Sci Program, Kalisizo, Uganda; Makerere Univ, Sch Publ Hlth, New Mulago Hill Rd,POB 7062, Kampala, UgandaRakai Hlth Sci Program, Kalisizo, Uganda
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